Timing and Efficacy of VATS Debridement in the Treatment of Parapneumonic Empyema

Objectives: Empyema thoracis is a common thoracic disease seen in both developing and developed countries. Despite modern management techniques, this condition is still associated with significant morbidity and mortality. Video assisted thoracoscopic surgery (VATS) has become an established mode of treatment for this condition; however the first-line approach and timing of surgical intervention remains controversial. The present study was undertaken to assess our experience of VATS debridement in the management of empyema, focusing on the timing of surgical intervention, and the affect this has on outcomes. Method: Between May 2007 and May 2011, 75 patients underwent VATS debridement of empyema in our institution. Retrospective analysis of clinical notes was performed to collect data regarding length of pre-operative conservative management, operative strategy and post-operative course. The primary outcomes were the need for open thoracotomy, post-operative complications, length of hospital stay and survival.